Taking Things Off the Table

President Barack Obama will address Congress and the nation this Wednesday night on the subject of health care reform. What he'll say is anyone's guess, at this point. Which (by the way) is exactly the problem he's trying to fix. Nobody's really sure what Obama will fight for, and what he will toss overboard in the name of political expediency. Even staunch Obama supporters would be hard-pressed to say, right now, what Obama will say in his speech this Wednesday. But whatever he says, one fact remains crystal-clear: Obama has got to be specific in his speech, or else the health care reform effort may collapse of its own weight soon after. And by being specific, Obama's got to start taking some things off the table. If Obama attempts more lofty (but detail-free) rhetoric, and does not (his other favorite metaphor for this situation) "draw bright lines in the sand," then he is going to disappoint a lot of people who voted for him because they thought he would be a good leader.

"The table" metaphor has run throughout this debate. Everyone was supposed to have "a seat at the table." Obama (and his advisors) absolutely love the phrase "everything's on the table." But the time for piling "everything" on "the table" is now over. Because everything still being on the table means, in essence, that no decisions have been made. If everything is the same priority, then you are not prioritizing at all. If you're for everything, then you wind up being for nothing specific. And against nothing, as well.

Here is David Axelrod, from yesterday's Meet The Press interview:

We've been through a long debate now. All the ideas are on the table. It's time to bring the strands together and get the job done for the American people here.

He went on to repeat the "all ideas are on the table" phrase twice more in his next answer.

This is a little disconcerting, although the "bring the strands together and get the job done" phrase seems to modify it a little bit. Because Barack Obama needs to realize that this speech will be a test for him. And to pass the test with the American people, the bare minimum is that he get specific -- about what he will accept and what he will not accept in healthcare legislation. At some point in the speech, Obama is going to have to use the word "veto" -- as in "I will veto any bill that comes to me that has X in it" (or "does not have X in it").

In other words, he's got to take some things "off" that metaphoric "table." Now, there are those who would argue (correctly) that some ideas never got on the table in the first place. Single-payer supporters, for instance. But to be fair, a few Republican ideas were banished from the table from the get-go as well. Tort reform is never allowed on any Democratic table, due to the influence of trial lawyers within the party. And the idea of "being allowed to buy health insurance across state lines" has never really been on the table either (although it may have rested on the edge of the table momentarily). Not that I'm saying either of these ideas is a good one or worth having, I'm merely pointing out that some ideas from both the right and the left have been completely excluded from this debate -- the "table" has never been as large as the "everything" language would have you believe, in other words.

But now it's crunch time. Obama's goals are well-known, since that's all he has talked about yet (as opposed to specifics about how to reach those goals). To be successful, health care legislation has got to: (a) reform the worst practices of the insurance industry, (b) cover everyone or at least make the attempt, (c) bring health care costs down in general, and (d) be paid for. The first one is the easy one -- banning "pre-existing conditions" and all the rest of the evil things health insurance companies do. Pretty much all the bills so far agree on this one. Universal coverage has been linked to mandating that everyone have some health insurance -- if either of these pieces get cut, the other one will likely be punted, too. This was what got the insurance companies to the table -- a huge pool of new customers forced to buy some insurance. Bringing costs down has been the hardest to achieve, and the least talked about. Because this is tough -- somebody's profits are going to have to get cut in order for this to happen. I've been following the debate pretty closely, and even I can't tell you what the best ideas are in regard to containing costs (especially since the best method -- that pesky single-payer option -- was banned from the table, so we can't even talk about it). And paying for it all is going to be a tough sell, because some taxes are going to have to be raised.

Obama has to talk about these details Wednesday. He's got to draw some sandy lines. He's got to pick up an idea from the table, examine it, and then toss it over his shoulder and say: "Nah, we're not going to do that, instead we're going to do this...."

By doing so, of course, he's going to annoy a lot of people. It doesn't even matter what he comes out for (or against), there will be some who so love (or hate) the idea that they're going to be upset by Obama's decision. That is the nature of decision-making and the nature of leadership. Not everyone gets what they want; but at least a new direction has been charted. This is the risk. This is why leadership is an inherently risky business. You could, after all, wind up being wrong. You could also stake out a political claim on one issue, and then lose because of that stance. But that is the nature of this game, and always has been.

Barack Obama made a political calculation earlier this year. He did so from over-learning the lesson of the failure of Clinton's health care reform. He decided that Congress would take all the heat and do all of the sticking out of necks and crawling out on limbs. Congress was left to their own devices to come up with the details of the plan. Obama stayed above the fray, offering encouragement from the sidelines, but not actual coaching. Democrats, being Democrats, wound up all over the map. Health care reform legislation is currently such a moving target that it is impossible to adequately defend -- because it simply can't be pinned down.

In other words, Obama thought he could "lead" on health care reform without staking out risky positions which might have caused his support to drop. He pushed bipartisanship long after it became obvious that Republicans were never going to vote for anything the president wanted. And, by doing so -- by supposedly taking the "safe" political route, to reduce risk of losing anyone's support -- Obama lost a lot of support anyway. The only difference is he didn't gain anything for this loss in support. If Obama had stood up strongly for one plan or another, and seen a 10-point drop in his job approval ratings, at least everyone could say: "He stood up for what he wanted, even though it cost him political capital to do so." Instead, Obama has lost those 10 points anyway -- for no gain whatsoever. He has squandered this political capital, instead of using it wisely.

But that's not to say he can't get it back. Obama could indeed start strongly leading on the issue, and stake out a firm position. Wednesday's speech could be the key turning point, if this does happen.

The big question, at least if you've been following the debate closely, is whether Obama will support the "public option" or not -- and how strongly. This is such a key issue that many of Obama's voters are ready to throw in the towel on Obama's presidency if he backs down on it. This is not just the rumblings of the far left, either, which is why I think some of the presidents' advisors don't adequately realize the scope of their problem here. There are a lot of middle-class voters who are thinking: "This is what he promised on the campaign trail, this is why I voted for him, and if he caves then I'm done with him." Some of them have already been disappointed by other Obama actions since he took office, but this is going to be the straw that breaks a lot of camels' backs out there among rank-and-file Obama voters.

So far, the Obama administration has (if you can believe the leaks) been toying with the "Olympia Snowe option" of having a public option with some sort of "trigger" mechanism which gives the insurance companies one last chance to get their act together. This must be tempting, politically, because it is a have-your-cake-and-eat-it-too position to take. "I'm for a public option -- in a bit," in other words. Obama can claim he hasn't tossed the public option overboard, and can make yet another hand-reaching gesture to Republicans (who are, of course, going to vote against it anyway). If you've paid close attention to Obama's administration so far, you can see why they're strongly considering taking this route. Whether it leads to open revolt on the left or not seems to be a risk Obama is willing to take.

But all the media leaks could be a feint. Obama has certainly done this before, sending the baying pack of brainless media hounds chasing after some red herring or another, only to surprise them by doing or saying something they didn't predict. This increases the "newsworthiness" of the event, because of the surprise factor. So just because you read what "high administration advisors" are saying in the newspapers, it may not turn out to be true. We'll all just have to wait until Wednesday night to see.

The only thing that is predictable about President Obama's speech to Congress is that it could indeed be a turning point in the whole debate. But that is a double-edged sword. Obama could regain momentum and whip his party's Congresscritters into shape, and wind up signing a sweeping piece of legislation before Christmas. But if Obama doesn't draw those lines in the sand, this could be the beginning of the end for health care reform during this legislative year. Because Congress can't stop squabbling, Obama has to lead. And he's got to lead by beginning the painful process of taking things off the metaphorical table, until what we are left with is something that can move forward and break the impasse in the Senate. "Everything is on the table" is fine for the beginning of the process. Even during most of the middle. But we are about to begin the end game here. And to reach that end, the table's got to shrink. Everything cannot be allowed to stay on the table.

And, Wednesday night, Obama has to tell us what will and what will not be allowed on the table, from this point on. He's got to lead on the issue. One way or another.